Individual
TRAVIS D EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1111 WINDOVER RD, JONESBORO, AR 72401-6159
(870) 936-8000
(870) 934-3653
Mailing address
PO BOX 1960, JONESBORO, AR 72403-1960
(870) 936-8000
(870) 934-3652
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-8862
AR
207QS1201X
Sleep Medicine (Family Medicine) Physician
E8862
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
221541003
—
AR
Enumeration date
05/30/2013
Last updated
08/10/2020
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